Organization
GRANT PHARMACISTS GROUP
Active
Other names
Total Care Pharmacy#3
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA G WILLIAMSON (MEDICAL RECORDS CLERK)
16068453421
Entity
Organization
Contact information
Practice address
40 BROADWAY ST, DRY RIDGE, KY 41035-9762
(185) 982-3020
(185) 982-3450
Mailing address
40 BROADWAY ST, DRY RIDGE, KY 41035-9762
(185) 982-3020
(185) 982-3450
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO7272
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5405293
—
KY
Enumeration date
09/30/2008
Last updated
09/30/2008
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